Health workforce featured healthcare workers' profiles and roles and factors for their attraction/retention. Crosscutting issues in strengthening access, organization of healthcare, and health workforce in rural areas were community action, outreach/visiting models, communication/information technologies, access to care, and professional training/development. The review provides a comprehensive understanding of primary care in rural health to promote equity for rural populations.The objectives of this study were to estimate the prevalence of use of electronic nicotine delivery systems (ENDS) and to explore the potential impact of ENDS use on smoking initiation with conventional cigarettes. We used data from the Risk and Protective Factors Surveillance System for Chronic Non-Comunicable Diseases Through Telephone Interview (Vigitel), 2019 edition, which interviewed 52,443 individuals 18 years or older in Brazil's 26 state capitals and the Federal District. Point prevalence rates and confidence intervals (95%CI) were calculated for current and ever use of ENDS in each state capital, and the profile of ENDS users were described. https://www.selleckchem.com/products/senaparib.html Prevalence of lifetime use was estimated at 6.7% (95%CI 6.13-7.27) and current use at 2.32% (95%CI 1.97-2.68). A total of 2.4 million individuals had used ENDS any time in life, and 835,000 were currently using them. Approximately 80% of persons who had used ENDS were 18 to 34 years-old. Prevalence rates for daily use and dual use in individuals aged 18 to 24 years were nearly 10 times than prevalence in the older age groups. More than half of individuals who had ever used ENDS were never smokers. The proportion of women and individuals with high educational level were higher in the group of young people who only used ENDS than among those who only smoked conventional cigarettes. ENDS users also presented a higher proportion of binge drinking. Our findings are opposite to the tobacco industry's argument that the target public for ENDS is adult smokers. Considering that groups purportedly less prone to using conventional cigarettes are experiencing initiation with ENDS, our findings call attention to the possible negative impact of the dissemination of ENDS on Brazil's successful experience in the fight against tobacco.This study aimed to analyze the association between incidence rates for gestational and congenital syphilis and coverage of prenatal care from 2007 to 2017 in the State of Bahia, Brazil. This was an ecological and longitudinal study in which the units of analysis were the municipalities (counties) of the State of Bahia. Secondary data were used, obtained from the databases of the Health Information Systems. Analysis of the association between the incidence rates and prenatal coverage was performed with panel datal, using the fixed model with negative binomial response, controlled for socioeconomic, demographic, and temporal variables. In the multivariate analyses, prenatal coverage showed a statistically significant positive association with gestational syphilis incidence rate, but no association was found with congenital syphilis the incidence rate. Using municipalities with prenatal coverage less then 45% as the reference group, the gestational syphilis incidence rate increased by 22% and 25%, respectively, in municipalities with prenatal coverage of 45%-64.9% (RR = 1.22; 95%CI 1.11-1.33) and ? 65% (RR = 1.25; 95%CI 1.10-1.43). The findings indicate that although the expansion of prenatal coverage in municipalities in Bahia has helped improve the detection of gestational syphilis, it did not impact the congenital syphilis incidence rate. Prenatal care as provided suffers limitations that should be the target of interventions to prevent and block vertical syphilis transmission.The article focuses on the experience of family and social frailty of children with congenital Zika virus syndrome (CZVS) and discusses the changes in support networks, in the sense of both their capacities and shortcomings. This qualitative study adopted a clinical-psychosociological approach. The study analyzed family narratives in 32 group meetings conducted in an outpatient setting in a referral research institute for CZVS care in the State of Rio de Janeiro, Brazil. The article presents part of the results from a larger study focused on understanding the psychosocial effects of illness and its impact on parenting and care of children with CZVS. The article concludes by discussing how parents' experience expresses complex processes that reveal family and social movements of support and recognition, but also, in the opposite sense, the lack of backup for mothers and fathers who struggle for recognition, social inclusion, and their children´s right to health and education.An association between non-alcoholic fatty liver disease (NAFLD) and pancreatic ductal adenocarcinoma (PDAC) has been previously suggested. This study aims at investigating this association and at identifying potential links between variables of the NAFLD spectrum and PDAC.
A cross-sectional case-matched analytical and comparative study was carried out to analyze patients undergoing surgical resection of PDAC and compare them to a control group of individuals undergoing cholecystectomy at a public tertiary teaching hospital, matched by sex, age and BMI. Hepatic histopathological examinations were compared between cases and controls.
Of 56 individuals, 36 were male (64.3%) and the median age was 61.5 years old (interquartile range 57.5 - 70). The participants' median BMI was 24.3 kg/m2 (interquartile range 22.1-26.2 kg/m2). Microvesicular steatosis (p=0.04), hepatocellular ballooning (p=0.02), fibrosis (p=0.0003) and steatohepatitis (p=0.03) were significantly more frequent in the group of cases. Odds ratios for hepatocellular ballooning (6.2; 95%CI 1.2-31.8; p=0.03), fibrosis (9.3; 95%CI 2.5-34.1; p=0.0008) and steatohepatitis (3.9; 95%CI 1.1-14.3; p=0.04) were statistically significant in relation to the PDAC prevalence.
Significant associations were identified between histopathological aspects of NAFLD (microvesicular steatosis, hepatocellular ballooning, fibrosis, and steatohepatitis) and PDAC.
Significant associations were identified between histopathological aspects of NAFLD (microvesicular steatosis, hepatocellular ballooning, fibrosis, and steatohepatitis) and PDAC.